Paper Wasp Sting

What is a paper wasp sting?

Paper wasp stings happen when these flying insects jab and inject you with venom using their stinger. These wasps range from 0.5 to 1 inch (13 to 25 millimeters) in length. They can be red, brown, black or orange, and often have yellow markings, especially on their face or abdomen. They get their name from the papery material they make to build their nests.

While paper wasp stings are painful, they’re usually not serious. But some people will have severe or systemic (body-wide) reactions like anaphylaxis and should seek emergency medical attention. You should also get medical attention quickly if you have a sting on or around your eyes or anywhere on your head, face or neck. Even if these stings don’t cause systemic or life-threatening reactions, the swelling can still be serious and dangerous.

Paper wasps are common worldwide and there are hundreds of species of them. These wasps live on every continent except Antarctica. They often build their nests, which are umbrella-shaped with a downward-facing comb of cells, in places like:

• Underneath overhangs, eaves and even door frames of homes and buildings
• Attics or rafters
• Under tree limbs and branches
• In bushes

Many other flying, stinging insects like yellowjackets or hornets also build paper nests. Some have very similar shapes to paper wasp nests. And paper wasps, hornets and yellowjackets are all related, making it hard to tell them apart.

What are the symptoms of a paper wasp sting?

Paper wasp sting symptoms are usually local (right around the sting). They include:

• Pain
• Redness
• Swelling (edema)
• Hives (urticaria)
• Itching (pruritis)
• Warmth around the site of the sting
• Mild fever (above 100.4 degrees Fahrenheit or 38 degrees Celsius)

Localized reactions usually go away within hours but can sometimes linger for days.

Large local reactions

In about 10% of cases, they can spread farther and/or be slightly more intense. Experts call those large local reactions. Some other differences possible with large local reactions include:

• Swelling severity: These can cause areas to swell up to 4 inches (10 cm) larger than their normal size.
• Pain severity: People often report large local reactions are even more painful.
• Timing and duration: Large local reactions usually start six to 12 hours after a sting and will get worse for one or two days. They can last between five and 10 days.

Systemic reactions

Systemic reactions range from mild to deadly. But systemic reactions can turn into life-threatening anaphylaxis in minutes. Call 911 (or your local emergency services number) if you notice any of the following changes in your:

• Breathing: Shortness of breath, wheezing, swelling around or in your mouth or having trouble swallowing
• Skin: Flushing, hives, itching or a rash (especially when they aren’t close to the sting site)
• Stomach: Nausea or vomiting, cramps or diarrhea
• Circulatory: Feeling dizzy or lightheaded, passing out (syncope) or circulatory (distributive) shock
• Heart: Heart rate changes or a weak pulse
• Nervous system: Seizures

Your risk of having anaphylaxis from paper wasp stings is higher if you previously had it from any kind of insect sting. Systemic (body-wide) reactions happen in about 3% of adults and up to 1% of children.

Delayed reactions (serum sickness)

You may develop a hypersensitivity reaction from a sting six days to two weeks after it happens. That’s called serum sickness. This happens as a delayed allergic reaction to the venom in the sting.

Serum sickness symptoms may include:

• Fever
• Muscle or joint pain
• Rash or hives
• Itching

These symptoms are usually not serious and often go away within days. But some effects may linger for a few weeks.

What makes paper wasps sting?

Paper wasps sting as a defense if they feel they or their nest are in danger. Research also shows that paper wasps aren’t as aggressive as yellowjackets or hornets.

Some key things to know about paper wasps include:

• They don’t leave a stinger behind. Wasps, hornets and yellowjackets don’t leave a stinger behind. This means they can sting you multiple times.
• They aim for your face. Stinging insects try to target your face and eyes if they can.
• They sting harder but use much less venom. Wasps can sting twice as hard as bees. But the average wasp sting injects one-tenth the venom of an average bee sting.
• They can sting in multiple directions. Wasps can rotate their bodies enough to sting upward, so holding them by the wings might still get you stung.
• They attack in small numbers. Usually, only one or a few wasps will try to sting you at a time.
• They’re more active depending on the time of day and year. Wasps are active during the day. Sting numbers in North America peak during August and September. Paper wasps typically go dormant in winter except in places with a warm climate year-round.

How is a paper wasp sting diagnosed?

A healthcare provider can usually diagnose a paper wasp sting by examining the sting and the symptoms you describe.

What tests will be done to diagnose a paper wasp sting?

Lab tests aren’t always necessary when you have a paper wasp sting. But tests are more likely if your provider suspects you have a sensitivity or an allergy to the stings. These can include blood tests, especially an allergy blood test, and other types of allergy testing. Tests on your pee (urinalysis) are possible for diagnosing delayed serum sickness reactions.

Other tests may be possible, especially if you’re having a more severe reaction. Your healthcare provider can tell you more about the possible tests.

How is a paper wasp sting treated?

Paper wasps usually don’t leave a stinger behind. If they do, remove it immediately. To do that, use something with a thin, dull edge (like a credit card or a butter knife). Hold the edge so it lies flat across your skin surface and scrape it toward the stinger. That should pull the stinger free. Don’t use tweezers to remove any kind of stinger (squeezing the stinger may inject more venom).

After you’re sure the stinger is out, keep an eye on your symptoms. If you’re severely allergic to insect stings and notice systemic reaction symptoms, act immediately. Use your prescribed epinephrine injector and then seek emergency medical care. If you’re not allergic, treat the sting with:

• Cold: Cold water or ice packs (wrapped in a towel to protect your skin from frostbite) can help with swelling.
• Elevation: Raising the affected body part higher than your heart can help with swelling.
• Antihistamines: Oral allergy medications like diphenhydramine (Benadryl®) may help with symptoms. You can also use hydrocortisone or calamine creams/lotions to ease itching and irritation.
• Pain relievers and anti-inflammatory drugs: Pain medications like acetaminophen (Tylenol®) may help. Your provider may also recommend nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Advil® or Motrin®) or naproxen (Aleve®). NSAIDs treat both pain and inflammation.

How are stings to the eye treated?

Stings around or directly to your eye need emergency medical care. That’s to prevent swelling and other effects from damaging your eye. Corneal stings are very painful because your corneas (and your eye surface in general) are highly sensitive.

Treatment for eye-related stings can vary. They may include antihistamines and medications to relieve pain and inflammation. Providers may also recommend procedures to flush venom out of your eye itself. Your provider can tell you more about the treatment options.

How are delayed serum sickness reactions treated?

Serum sickness reactions usually go away on their own, but providers often prescribe treatment to ease your symptoms. In the most severe cases, you may need to stay in the hospital for a few days. Your healthcare provider can tell you more about what to expect in your case.

Do home remedies for minor stings work?

Home remedies for stings are common. Some common examples include putting a paste on the sting. The paste can consist of water and either baking soda or meat tenderizer (when it contains the enzyme papain).

Research shows these home remedies aren’t effective (no matter how much or how many people swear by them). But they also aren’t likely to hurt you either.

Can paper wasp stings be prevented?

Paper wasp stings are often preventable, or you can at least lower your risk of them happening. Some key things you can do include:

• Watch for and avoid their nests.
• Don’t antagonize, startle or swat at them.
• Don’t wear floral colors or patterns.
• Don’t wear or use scented cosmetics or other items.
• Close and seal garbage cans or toters.
• Don’t leave food (including pet food) outside.
• Don’t pick up stunned or dead wasps with your hands (you can still get a sting this way).
• Clear out their nests (when they’re less active, which is when the sun is down).
• Run away (cover your nose and mouth as you run if multiple wasps try to sting you).

Severe reaction prevention

Venom immunotherapy is a preventive treatment that may lower your risk of having a severe systemic reaction. This treatment gradually exposes you to small amounts of bee or wasp venom in increasing doses over time. That teaches your immune system not to overreact to it.

Success rates for venom immunotherapy range from 80% to 95%. The risk of sting-related anaphylaxis after completing a treatment series is under 5%. But people who complete venom immunotherapy should still always carry an epinephrine autoinjector.

What can I expect if I get a paper wasp sting?

In general, the outlook for paper wasp stings is good. Fortunately, for most people, symptoms like pain and swelling usually go away within a matter of hours or a few days.

But if you have a stronger reaction to a paper wasp sting, it can become a serious concern. Systemic reactions may start mild, but they can quickly turn life-threatening. That’s why you should always treat systemic reaction symptoms like a medical emergency.

What questions should I ask my provider?

If you have a paper wasp sting and get medical attention, it’s a good idea to ask your provider:

• How do I treat the remaining sting symptoms properly?
• What kinds of symptoms mean I should call your office?
• What symptoms mean I need emergency medical care?

You may also want to ask about venom immunotherapy if you have a history of severe sting reactions.

Do paper wasp stings get infected?

Paper wasp stings (and stings in general) usually don’t get infected on their own. But scratching the sting site may let germs from your hands enter the wound and cause an infection.

Do wasp stings hurt more than bee stings?

It depends. The Schmidt Sting Pain Index rates sting pain from 0 (least painful) to 4 (most painful). Bee stings rate a 2. Paper wasp stings rate 2 or 3, depending on species.

Still, it’s hard to say definitively if one hurts more than the other for two main reasons:

• Location of the sting: Stings on sensitive areas of your body hurt more.
• Pain is subjective: What hurts terribly for one person may not hurt much at all for another.